Your browser doesn't support javascript.
loading
Sarcoidosis diagnosed on granulomas in the explanted heart after transplantation: Results of a French nationwide study.
Chazal, Thibaud; Varnous, Shaida; Guihaire, Julien; Goeminne, Céline; Launay, David; Boignard, Aude; Vermes, Emmanuelle; Dorent, Richard; Camilleri, Lionel; Lelong, Bernard; Epailly, Eric; Lebreton, Guillaume; Waintraub, Xavier; Cluzel, Philippe; Maksud, Philippe; Fouret, Pierre; Leprince, Pascal; Grenier, Philippe; Amoura, Zahir; Cohen Aubart, Fleur.
Afiliação
  • Chazal T; Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital De la Pitié-Salpêtrière, Service de Médecine Interne 2, Centre de Référence National Maladies Systémiques Rares, 75013 Paris, France.
  • Varnous S; Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital De la Pitié-Salpêtrière, Service de chirurgie cardiaque, 75013 Paris, France.
  • Guihaire J; Service de chirurgie cardiaque, Hôpital Marie Lannelongue, Université Paris Sud, 92350 Le Plessis-Robinson, France.
  • Goeminne C; Service de cardiologie, Centre Hospitalier Universitaire de Lille, 59000 Lille, France.
  • Launay D; Service de Médecine Interne, Centre Hospitalier Universitaire de Lille, Centre National de Référence des Maladies Auto-immunes et Systémiques Rares du Nord-Ouest (CERAINO), Université de Lille, U995, 59000 Lille, France.
  • Boignard A; Service de chirurgie cardiaque, Centre Hospitalier Universitaire de Grenoble, 38700 La Tronche, France.
  • Vermes E; Service de chirurgie cardiaque, Centre hospitalier Universitaire de Tours, Hôpital Trousseau, 37044 Tours, France.
  • Dorent R; Service de chirurgie cardiaque, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, 75018 Paris, France.
  • Camilleri L; Service de chirurgie cardiaque, Centre hospitalier Universitaire de Clermont-Ferrand, 63000 Clermont-Ferrand, France.
  • Lelong B; Service de chirurgie cardiaque, Centre hospitalier Universitaire de Rennes, 35000 Rennes, France.
  • Epailly E; Service de chirurgie cardiaque, Centre hospitalier Universitaire de Strasbourg, 67091 Strasbourg, France.
  • Lebreton G; Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital De la Pitié-Salpêtrière, Service de chirurgie cardiaque, 75013 Paris, France.
  • Waintraub X; Sorbonne université, Assistance Publique-Hôpitaux de Paris, Hôpital De la Pitié-Salpêtrière, Département de cardiologie médicale, 75013 Paris, France.
  • Cluzel P; Sorbonne université, Assistance Publique-Hôpitaux de Paris, Hôpital De la Pitié-Salpêtrière, Département d'imagerie Cardiovasculaire, 75013 Paris, France.
  • Maksud P; Sorbonne université, Assistance Publique-Hôpitaux de Paris, Hôpital De la Pitié-Salpêtrière, Service de Médecine Nucléaire, 75013 Paris, France.
  • Fouret P; Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital De la Pitié-Salpêtrière, Service d'Anatomopathologie, 75013 Paris, France.
  • Leprince P; Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital De la Pitié-Salpêtrière, Service de chirurgie cardiaque, 75013 Paris, France.
  • Grenier P; Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital De la Pitié-Salpêtrière, Service de Radiologie, 75013 Paris, France.
  • Amoura Z; Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital De la Pitié-Salpêtrière, Service de Médecine Interne 2, Centre de Référence National Maladies Systémiques Rares, 75013 Paris, France.
  • Cohen Aubart F; Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital De la Pitié-Salpêtrière, Service de Médecine Interne 2, Centre de Référence National Maladies Systémiques Rares, 75013 Paris, France. Electronic address: fleur.cohen@aphp.fr.
Int J Cardiol ; 307: 94-100, 2020 05 15.
Article em En | MEDLINE | ID: mdl-32122700
BACKGROUND: Cardiac sarcoidosis (CS) is a challenging diagnosis. Patients may progress to end-stage congestive heart failure and require cardiac transplantation without ever having been diagnosed. Characteristics and outcomes of patients with granulomas in the explanted hearts are unknown. METHODS: All French heart transplantation centers were contacted to participate in the study. Each center searched through local databases for the cases of non-caseating granuloma in the explanted hearts between 2000 and 2017. Data before and after transplantation were recorded from medical charts. Survival of CS and all- cause heart transplantation patients were compared. RESULTS: Fifteen patients (10 men, 5 women) received a diagnosis of CS based on pathologic data of the explanted heart and were recruited for the study. All patients were diagnosed as non-ischemic dilated or hypertrophic cardiomyopathy and presented congestive heart failure. Eight patients (53%) had ventricular rhythm disturbances, and 3 (20%) a complete heart block. Ten out of 13 patients (77%) had extracardiac radiological signs compatible with sarcoidosis on chest computed tomography (CT) scans. One patient died 3 months after transplantation from infectious complications. The 14 remaining patients were still alive at the end of the study (median follow-up of 28.8 months). One patient had a second heart transplantation 5 years later because of chronic allograft vasculopathy. One patient presented a relapse of CS confirmed by myocardial biopsies 9 years after transplantation, requiring an escalation of immunosuppressive therapy. CONCLUSION: CS may be undiagnosed before heart transplantation. In 77% of cases, sarcoidosis could have been detected before transplantation with non-invasive imaging techniques.
Assuntos
Palavras-chave

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Sarcoidose / Transplante de Coração / Insuficiência Cardíaca / Cardiomiopatias Idioma: En Ano de publicação: 2020 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Sarcoidose / Transplante de Coração / Insuficiência Cardíaca / Cardiomiopatias Idioma: En Ano de publicação: 2020 Tipo de documento: Article